Diagnosis

When teen depression is suspected, the doctor will typically do these exams and tests.

Physical exam. The doctor may do a physical exam and ask in-depth questions about your teenager's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem.

Lab tests. For example, your teen's doctor may do a blood test called a complete blood count or test your teen's thyroid to make sure it's functioning properly.

Psychological evaluation. This evaluation includes a discussion with your teen about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications.

Your mental health provider may use the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose major depression.

Types of depression

Symptoms caused by major depression can vary from person to person. To clarify the type of depression your teen has, the doctor may use one or more specifiers, which means depression with specific features. Here are a few examples:

Anxious distress — depression with unusual restlessness or worry about possible events or loss of control

Melancholic features — severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness

Atypical features — depression that includes the ability to be temporarily cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in arms or legs

Other disorders that cause depression symptoms

Several other disorders include depression as a symptom. An accurate diagnosis is the key to getting appropriate treatment. The doctor or mental health provider's evaluation will help determine if the symptoms of depression are caused by one of these conditions:

Bipolar I and II disorders. These mood disorders include mood swings that range from major highs to major lows. It's sometimes difficult to distinguish between bipolar disorder and depression.

Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.

Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.

Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent functioning normally in daily routines and from living life to its fullest.

Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of a menstrual period, and are minimal or gone after the period ends.

Other causes of depression. This includes depression that's caused by the use of recreational drugs, certain prescribed medications or another medical condition.

Depression in children and adolescents. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/depression/depression-in-children-and-adolescents.shtml. Accessed Sept. 8, 2015.

A family guide: What families need to know about adolescent depression. National Alliance on Mental Illness. http://www2.nami.org/Template.cfm?Section=Child_and_Adolescent_Action_Center&template=/ContentManagement/ContentDisplay.cfm&ContentID=24806. Accessed Sept. 8, 2015.

Facts for families: Psychotherapies for children and adolescents. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Psychotherapies_For_Children_And_Adolescents_86.aspx. Accessed Sept. 8, 2015.

Hall-Flavin DK, et al. Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting. Pharmacogenetics and Genomics. 2013;23:535.

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